We Soothe.In-Home Massage Inquiry And Booking Form

Please call 800-834-8350 or fill out the form below to book a session now.

Your Name:

Please Digitally Sign by Entering Your Initials Here:

E-Mail Address:

Cell Phone Number:

Is this your first time booking with We Soothe? Yes No

Are you booking a session for TODAY? Yes No

If not, what's the date of the session you're interested in:

Time of session:

Duration:

Is this a couples massage or massage for an individual?
one therapist for one person
two therapists for two people (couples massage)
two therapists for one person (4-hand)

If you are requesting a specific therapist by name please enter the therapist's name here:

All our therapists are competent and among the top in the field. As Health Care Providers, we feel that gender is irrelevant. However, if you have a preference, please let us know. We wish to accomodate you, not impose our worldview.
any gender would be fine
female(s) would be preferred, but not mandatory
male(s) would be preferred, but not mandatory
female(s) only
male(s) only
one male and one female preferred.
send a Martian; I could care less. If they're a great therapist, it's A-OK.

What is the gender of the person(s) receiving a massage?

What region?

House Number and Street Name where the session will take place:

Town or City:

Neighborhood or Development:

Type of residence:

What floor will the session take place on?

What is the apartment or unit number or designation?

If there are special parking procedures, please state here:

Is there an elevator? No Yes

If the session is for someone other than yourself, please state the person's name and your connection with them.

Modalities you're interested in: (Please check ALL that may apply; multiple modalities may be combined in one session at no added cost, with the exception of Hot Stone.)

Swedish Massage

Harder Pressure Swedish Massage

Shiatsu

Postnatal Massage

Deep Tissue

Craniosacral Therapy

Myofascial Technique

Prenatal Massage

Sport Massage

*Hot Stone is the only technique that carries an added surcharge.

Any technique/modality not stated? Please list here:

Anything else you'd like us to know to be prepared for your session? Include it here!

Would you like to pay now by credit card? Yes No

<-- (Please click 'Submit' at left to continue.

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